America's anthrax scare continues, with cases now reported in four areas of the country. In Florida - where the first anthrax case was recorded three weeks ago - health officials are struggling to keep up with a sudden surge in demand for their services and expertise.

Many Americans say they are worried about anthrax and the possibility of contracting it from tainted letters sent though the mail. In Miami, Joe Williams manages an export-import company. He says his staff is taking precautions that would have been unimaginable just a few weeks ago.

"We have provided our mail handlers with latex gloves, protective masks and plastic baggies," he says. Health officials say caution is warranted, but hasten to make a distinction between reasonable concern and absolute panic.

Since the anthrax scare began, south Florida hazardous materials units and local health departments have had to respond to thousands of calls from people reporting suspicious packages and other incidents. The vast majority of samples collected have tested negative for anthrax.

The director of Miami-Dade County's Health Department, Jim James, says laboratory workers have been overwhelmed. "The hazmat, hazardous materials, response could not be adapted to 150 to 200 calls a day," he said. "We had to go into a seven day a week, 24-hour capability. At a certain point, you just can not process the samples fast enough to really catch up," he said.

Dr. James says the backlog of environmental samples has become so severe that delays in testing have grown from several hours to several days. Nevertheless, Dr. James says he is proud of the work that has been done.

"I think what has happened here in Florida is a wonderful example of public health in action. Thank goodness it was not a large scale exposure," he said. "But when you look at the timeframes from the initial incident to the laboratory confirmation of what was going on, and the public health response, I think it was superb. Does that mean it was flawless? No," he said.

One flaw identified by Dr. James is a lack of coordination among federal, state, and local officials in getting essential anthrax-related information to the public. He says that in times of uncertainty, America's public health system must speak with one voice.

"What is the one big lesson learned? From my perspective, it is the importance of communication and the public message," Dr. James says. "It is having procedures in place so that we get good, solid information to the public. So much of what has gone on with anthrax could have been dampened with public education, and that is one area we need to improve on," he says.

Dr. James insists the public health system is dealing effectively with the current anthrax scare. But he points out the ongoing anthrax exposure outbreak has been relatively small scale to date, affecting only a couple dozen people in several cities. He says the real test would come if another biological threat arises affecting thousands, or tens of thousands of people or more, over a broad region.